Alprazolam/fluoxetine/mixed-amfetamine-salts

Abstract

Worsened brain fog and memory impairment: case report A man in his 20s developed worsened brain fog and memory impairement during treatment with alprazolam, fluoxetine and mixed-amfetamine-salts [routes and dosages not stated]. The man, who had an 18 month history of persistent neurological and behavioural symptoms secondary to a sports-induced concussion, presented to the clinic at the age of 24 years. In October 2017, he had a head injury while playing in a collegiate-level sport. After a medical assessment, the physician advised him for prolonged rest for several months. However, his symptoms did not resolve. Hence, he was referred to a local academic-medicine concussion clinic where psychological services prescribed alprazolam [Xanax] for anxiety, fluoxetine [Prozac] for depression and mixed-amfetamine-salts [Adderall] for management of pain and impaired concentration. He reported improvement in his ability to focus on job tasks with mixed-amfetamine-salts therapy. However, brain fog and memory impairement worsened due to alprazolam, fluoxetine and mixed-amfetamine-salts [durations of treatments to reactions onsets not stated]. Anamnesis revealed history of multiple concussions and other sports-related injuries. During an interview, he reported multiple post concussion symptoms including headaches, neck pain, sinus trouble, loss of memory (short term and immediate recall), depression, anxiety, dizziness, social gathering intolerance, loss of balance, tinnitus, hypersensitivity to light and sound, shortness of breath and sleep problem. He received treatment with craniosacral therapy, manual lymphatic drainage and glymphatic techniques. After eleven treatment sessions over 3 months period, improvement was noted. Additionally, brain pressure and foggy feeling improved. Post-concussion syndrome symptom severity was reduced by 87%. Additionally, he achieved relief from chronic headaches. A 6 month follow-up revealed symptoms remained abated with full re-engagement of daily activities.